**/****

LPN

Lorain County Comm College

Elyria, OH

aduxdt@r.postjobfree.com

570-***-****

Charlotte, NC 28208

Skills

• Billing Dispute Resolution

• Audit Procedures

• Accounts Receivable Expertise

• Invoicing Proficiency

Education And Training

I enjoyed my nursing career, however, I took off several years to love my children and raise them in the most responsible ways to prepare them for their successful careers. Eventually, I acquired experience in medical billing and started my own business. I loved that work. It was very challenging and financially lucrative. I enjoyed meeting various office managers once a week, when I would travel to their offices to pick up reports. After many years, I moved out of state and started a job position as a Billing Specialist for a wonderful company called Hospice of the Sacred heart. It was amazing to work there and the people at that company were so devoted to easing the suffering of hospice patients and their families. Subsequently, I moved to Charlotte NC to be near some of my children. I haven't worked fin the past 2 years, enjoying retirement. Now I see that I miss working. I don't want to start another business of my own. I'd like to work part-time doing data entry or assist another company in their work. Hospice Of The Sacred Heart - Billing Specialist

Wilkes-Barre, PA

09/2016 - 07/2020

ARP Billing Service - Owner

Peru, NY

01/1993 - 08/2015

Dolores Bradshaw

Summary

Experience

• Submitted claims to insurance companies.

• Reconciled codes against services rendered.

• Performed insurance verification, pre-certification and pre-authorization. Assessed billing statements for correct diagnostic codes and identified problems with coding.

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Remained up-to-date details of patient financial responsibilities, fee-for-service and managed care plans by participating in training programs.

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• Accurately coded diagnostics and prepared billing statements for patients.

• Posted charges, payments and adjustments.

Analyzed and interpreted patient medical and surgical records to determine billable services.

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• Meticulously tracked and resolved underpayments.

• Completed appeals and filed and submitted claims. Contacted insurance providers to verify insurance information and obtain billing authorization.

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Posted surgeries, hospital visits and payments for assigned carriers within

[Timeframe].

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• Reviewed and verified benefits and eligibility with speed and precision.

• Maintained current working knowledge of CPT and ICD-10 coding principles, Good Samariton Hosp & Private Duty - Licensed Practical Nurse Cincinnati, OH

08/1977 - 06/1986

government regulation, protocols and third-party billing requirements. Maintained timely and accurate charge submission through electronic charge capture, including billing and account receivables (BAR) system and clearing house.

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Prepared and attached referrals, treatment plans or other required correspondence to reduce incidence of denials.

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Identified errors and re-filed denied or rejected claims quickly to prevent payment delays.

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Contacted patients for unpaid claims for HMO, PPO and private accounts and performed friendly follow-ups to ensure proper payments were made according to contracts.

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• Precisely completed appropriate paperwork and system entry regarding claims.

• Submitted refund requests for claims paid in error.

• Posted and adjusted payments from insurance companies. Entered procedure codes, diagnosis codes and patient information into

[Software].

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Evaluated accuracy of provider charges, including dates of service, procedures, level of care and diagnoses, identifying over [Number] errors within [Timeframe].

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• Thoroughly reviewed remittance codes from [Type] and [Type] sources.

• Oversaw regulatory and strategic initiatives to ensure accuracy of medical claims. Kept detailed and accurate documentation of payments, charges and write-ups of cardiovascular procedures.

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• Applied payments, adjustments and denials into medical manager system.

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